Canadain Feline needs urgent help.

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Justin

Justin

Member Since 2018
Hi all, I posted in introduction forum and was well received :)

I will try and keep this as to the point as I can. I need help, my feline buddy was diagnosed just over a year ago and we were put on lantus. I switched his food from a dry food to fancy feast wet Pate(Canada)

He has since lost a lot of weight, at first I thought that was good, on a recent visit to the vet for an unrelated matter the vet told me I need to control his food/insulin better as he will not survive as skin and bones :( Agreed maybe I am not doing it right...

Which brings me here, I need desperate help here.

My feline has not been eating right the last few days, he tends to leave the food and just pick at it sometimes, I keep throwing it out and giving him new hoping it would intice him. Yesterday I went and got friskies pate and he did eat one can. He is not eating enough food and even when he was he was loosing weight. I fear I am messing up with his insulin or something else at play.

He was eating 4 small cans of fancy feast Pate a day. We were giving him 3 units of lantus one daily. I do have a home human blood checker that we haven't used in awhile. The confusion of when to test and what numbers we need escapes me. I feel as though he needs more insulin but if he is not eating could I not do more harm than good here?

He is 15yrs old, he is getting less mobile, is not eating enough. Lantus is given everyday once only. I do not want to give him insulin blinding and need some good advice.

If you need to know more about any part of this please ask so we can work together and save my feline friend.

For the vets part.... they diagnosed him, gave me a paper about it, severly overcharged me for lantus and sent me on my way. I feel as though if I did everything on the paper he would no longer be here already.

Time is of no importance to us, I work full time however my wife is currently off on leave. She has all the time this may require to get him better.

Thank you all for reading and I hope to hear something from you. Perhaps we can start at the beginning and pretend I am new. We do know how to give insulin and how to check blood, that alone is not enough :(
 
Here are some basics for new people like yourself:
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It would help us if you set up your signature (light grey text under a post). Here's how:
  • click on your name in the upper right corner of this page
  • click on "signature" in the men that drops down
  • type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.
Another thing that will help us help you now that you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and will look at it before offering any dosing advice: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
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Here's the basic testing routine we recommend:
  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your SS, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
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Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high:
  1. BG goes low OR lower than usual OR drops too quickly.
  2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
  3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
  4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
  5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
  6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
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Here are some tips on how to do urine ketone testing (VERY important of BG is high and kitty isn't eating well!):
  • put the end of the test strip right in his urine stream as he's peeing
  • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
  • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.

Ask any/all questions you have here on this forum. :)
 
Thank you for that, I will follow along and do everything you said. I have already updated signature

The spreadsheet looks confusing to me, I did want to start one myself but this one looks hard to follow. I do not know what most of it means
 
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Justin said:
Hey thanks for that, easier to understand for sure. I am guessing I need to change my meter? I get numbers for mmol/L So say i test him right now it will read 9.6 mmol/L the numbers on spreadsheet are a lot higher, I presume because feline blood is measured different?
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No need to change your meter. It was bought in Canada so it reads out in Canadian units of mmol/L. Choose the spreadsheet template for world units. That's what we use in Canada. The US measures BG in different units (mg/dL) and the numbers will be higher when you look at US spreadsheet. If you set up the world unit spreadsheet (SS) and enter your mmol/L numbers it automatically converts them so they show up in US units on the US version of the SS. There's a tab at the bottom of the SS you click on to see the US version. Very clever!
 
Re meters: a human meter will read lower than a pet meter like the AlphaTrak2 that many vets want us to use. The test strips for those are very expensive though. Human meter strips, although still expensive in Canada, are about half the cost or a bit less. You'll use quite a few if you want to get your kitty doing better.

It's important to know that the "take action" BG on a human meter is 50. That means the BG is dropping too low (not hypo just too low) and you need to feed a low carb snack to prop it up.
 
As soon as I can find him I am going to test him. He has not eaten in hours, hasent touched food set out for him in last while :(
 
Kris & Teasel said:
Re meters: a human meter will read lower than a pet meter like the AlphaTrak2 that many vets want us to use. The test strips for those are very expensive though. Human meter strips, although still expensive in Canada, are about half the cost or a bit less. You'll use quite a few if you want to get your kitty doing better.

It's important to know that the "take action" BG on a human meter is 50. That means the BG is dropping too low (not hypo just too low) and you need to feed a low carb snack to prop it up.
Click to expand...

He has been tested at 22.9 mmol/L and hasent eaten that I know of in hours...

Should I give him a shot even without food?

this is the confusion here, my wife says not to give him lantus unless he ate... but in my mind he is high already and needs it.
 
Should I give him a shot even without food?[/QUOTE]

Sorry - just seeing this now. He needs insulin. I suggest you drop his dose to 2 u and inject now. Offer small amounts of food frequently over the next two hours or so. It takes about that long to reach Lantus' onset. If he refuses cat food, try tuna, sardines, salmon, plain chicken or even plain meat human baby food (that has no seasonings, etc.)
 
Kris & Teasel said:
Should I give him a shot even without food?
Click to expand...

Sorry - just seeing this now. He needs insulin. I suggest you drop his dose to 2 u and inject now. Offer small amounts of food frequently over the next two hours or so. It takes about that long to reach Lantus' onset. If he refuses cat food, try tuna, sardines, salmon, plain chicken or even plain meat human baby food (that has no seasonings, etc.)[/QUOTE]

Consider it done, thank you, will update spreadsheet :)
 
It's important that you test his BG at +2 (ie., 2 hours after this shot in SS language). That can show you if a big drop might happen this cycle (cycle = the 12 hours after a shot). If the +2 is significantly lower than the recent pre shot of 22.9 you have to be ready to test more often to track his BG as he gets to nadir (nadir = point of maximum action of insulin dose where BG will be lowest).
 
Lantus is meant to be dosed twice a day! You were giving 3 units once a day. Your vet has steered you wrong with dosing. If you go to the Lantus forum, at the top are yellow stickies about the insulin. There are also two explanations of possible protocols you can follow. Tight Regulation, and Start Low Go Slow. http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/ Please read through them. If you follow one of these protocols I think it will take some of the guesswork out of what you should do next. i'm glad you have a meter and know how to use it. Get in the habbit of using it DAILY. It is your number one best tool to keep your cat safe, get him healthy, and find a dose that works for him.
 
Justin said:
Sorry - just seeing this now. He needs insulin. I suggest you drop his dose to 2 u and inject now. Offer small amounts of food frequently over the next two hours or so. It takes about that long to reach Lantus' onset. If he refuses cat food, try tuna, sardines, salmon, plain chicken or even plain meat human baby food (that has no seasonings, etc.)
Click to expand...

Consider it done, thank you, will update spreadsheet :)[/QUOTE]
good job getting that spreadsheet and signature set up so quickly! You just took your first major step in the right direction! Glad you found this site. :)
 
Kris & Teasel said:
It's important that you test his BG at +2 (ie., 2 hours after this shot in SS language). That can show you if a big drop might happen this cycle (cycle = the 12 hours after a shot). If the +2 is significantly lower than the recent pre shot of 22.9 you have to be ready to test more often to track his BG as he gets to nadir (nadir = point of maximum action of insulin dose where BG will be lowest).
Click to expand...

I am ready to do what it takes to get this sorted out for him!
 
JanetNJ said:
Lantus is meant to be dosed twice a day! You were giving 3 units once a day. Your vet has steered you wrong with dosing. If you go to the Lantus forum, at the top are yellow stickies about the insulin. There are also two explanations of possible protocols you can follow. Tight Regulation, and Start Low Go Slow. http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/ Please read through them. If you follow one of these protocols I think it will take some of the guesswork out of what you should do next. i'm glad you have a meter and know how to use it. Get in the habbit of using it DAILY. It is your number one best tool to keep your cat safe, get him healthy, and find a dose that works for him.
Click to expand...

Hey good advice thank you! I have no issues with testing a lot, its an expense but he is worth every penny :)
 
Justin said:
we were put on lantus. I switched his food from a dry food to fancy feast wet Pate(Canada)
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Good insulin and good food for diabetic cats. Friskies pates are fine too - just not the indoor cat types with the green lid. It's best to avoid all kibble. Good treats to give around testing/injecting are freeze dried meat treats. Pure Bites and Orijen are two brands. Pure Bites are available in Pet Smart stores. Canadian Tire has a similar type called Pure Snacks. I've used both. Orijen brand is generally sold in health food/holistic pet stores.
 
JanetNJ said:
Consider it done, thank you, will update spreadsheet :)
Click to expand...
good job getting that spreadsheet and signature set up so quickly! You just took your first major step in the right direction! Glad you found this site. :)[/QUOTE]

I am SO glad I found this forum, so far you have exceeded my expectations :)
 
I am setting up a tablet dedicated to this venture, this way my wife and I can use it to update spreadsheet without added distractions. I just so happen to have a tablet I dont use here so I am doing that all now. It is another tool I will keep with the Glucose meter. Thank you all again for helping me out, what a great group you have here :) I hope one day I too can help people on here once I get a hang of this
 
Justin said:
My feline has not been eating right the last few days, he tends to leave the food and just pick at it sometimes, I keep throwing it out and giving him new hoping it would intice him. Yesterday I went and got friskies pate and he did eat one can. He is not eating enough food and even when he was he was loosing weight
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Pay very close attention to his food intake. If needed, coax him with other foods. Worst case, puree some canned food with a little water and syringe feed him. You need syringes 20 mL plus with no needle and a large opening. Try a human pharmacy. Not enough food and high BG increases the risk of ketone development. They can become very ill and treatment is $$$$.

Justin said:
He was eating 4 small cans of fancy feast Pate a day. We were giving him 3 units of lantus one daily. I do have a home human blood checker that we haven't used in awhile. The confusion of when to test and what numbers we need escapes me. I feel as though he needs more insulin but if he is not eating could I not do more harm than good here?
Click to expand...
Unregulated diabetic cats are always hungry unless they're feeling ill. Feed as much low carb wet food as he wants in several small meals a day. Just take food away two hours before every pre injection BG test. Lantus MUST be injected twice a day in cats. They metabolize insulin quickly and one injection won't control BG for 24 hours. We can help you get that working.

Justin said:
He is 15yrs old, he is getting less mobile,
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It could be arthritis or he might be suffering from diabetic neuropathy. Is he walking low near his heels on his back legs? That's a sign of neuropathy. Good BG control will help and you can also give a vitamin B12 supplement. Human pharmacies carry that in pill form. You want about 1000 mcg of the methylcobalamin version of B12 in a pill that has no added sugars. These dissolve easily in warm water and you can mix it right into wet food because they're tasteless.

Justin said:
For the vets part.... they diagnosed him, gave me a paper about it, severly overcharged me for lantus and sent me on my way. I feel as though if I did everything on the paper he would no longer be here already.
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Here's a very useful bit of info: you can buy Lantus over the counter in human pharmacies in Ontario. Not sure about the rest of Canada but you can ask at a pharmacy. It's a lot cheaper than what your vet will charge. If you can go this route, but a 5 pack of Lantus pen cartridges (don't bother with the whole pen). Each cartridge is 3 mL so that's a total of 15 mL of insulin for about the price of a 10 mL vial if purchased in a human pharmacy (about $100-$125 in Ontario). You'll use up a 3 mL cartridge long before it loses it's oomph. The 5 pack will last properly stored in your fridge until the pack's expiry date, usually 2 years or so down the line.
 
Yes for example the vet charged $230 plus taxes for a vial of lantus... I got the same vial (after my wife broke ours from vet) at costco for $62.00 NO TAX. Same vial! Insane!
 
Justin said:
Yes for example the vet charged $230 plus taxes for a vial of lantus... I got the same vial (after my wife broke ours from vet) at costco for $62.00 NO TAX. Same vial! Insane!
Click to expand...
The 10 mL vial contains 1000 units of Lantus. If you've been giving 3 u a day that's 333 days of doses or almost a year. Problem is, by 6 months that Lantus is probably not potent enough any longer. I'm sure Costco pharmacy carries the 5 pack of cartridges - much better way to go. That begs the question: how old is your current Lantus vial?
 
Kris & Teasel said:
The 10 mL vial contains 1000 units of Lantus. If you've been giving 3 u a day that's 333 days of doses or almost a year. Problem is, by 6 months that Lantus is probably not potent enough any longer. I'm sure Costco pharmacy carries the 5 pack of cartridges - much better way to go. That begs the question: how old is your current Lantus vial?
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They do sell the 5 pack as well, was more money bu thats fine if its better? How do you extract the insulin from the cartridge? Current vial is 3 months old
 
Justin said:
They do sell the 5 pack as well, was more money bu thats fine if its better? How do you extract the insulin from the cartridge? Current vial is 3 months old
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When you look at the cartridge you'll see that there's a little grey rubber seal on one end. You put the needle through that. You don't inject any air into the cartridge like you would with the vial. As you withdraw insulin doses there's a rubber plunger device inside the cartridge that moves slowly toward the rubber seal end over time.

And, yes, the cartridge pack is definitely better value. You'll probably have to discard your vial well before its finished and that's wasted money. If you keep using it past about the 6 month mark you'll start to see it losing its BG lowering effect or else you'll see little snowflake like "floaters" in it.
 
I am going to check him again its been a couple hours since shot. Does it matter when I check him? by the way he has eaten, not as much as normal but he did get some into him :)
 
For insulin extraction from pens, I do the same thing for Leo's levemir pens. As Kris said, it is better to not inject any air. I have been using the pens for over a year now. Pretty handy and they have a cap to keep the top clean.
 
JeffJ said:
For insulin extraction from pens, I do the same thing for Leo's levemir pens. As Kris said, it is better to not inject any air. I have been using the pens for over a year now. Pretty handy and they have a cap to keep the top clean.
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We can buy cartridges without the pen case here in Canada, Jeff. I keep the little plastic cover each cartridge is in and put it back in after use, then into a snack baggie to keep it clean.
 
This could be a good day for a 12 hour curve. Basically you test every 2 hours (6 tests). Food is provided after each test, then put away after eating. So it looks like:
- AMPS test, then food
- +2hrs test, then food
etc
- PMPS test, then food, then look at results

It wouldn't be a perfect curve today. But you could start at the 4 hour mark.
 
JeffJ said:
This could be a good day for a 12 hour curve. Basically you test every 2 hours (6 tests). Food is provided after each test, then put away after eating. So it looks like:
- AMPS test, then food
- +2hrs test, then food
etc
- PMPS test, then food, then look at results

It wouldn't be a perfect curve today. But you could start at the 4 hour mark.
Click to expand...

I'll do it. Will that help me determine what next shot should be at tonight?
 
cool, I hope someone can advise me when the time comes this eve :) I will test him every 2 hrs as stated, I will update his spreadsheet as we go, I just set up the tablet for this purpose :)
 
Doing well so far today! :) Stubborn is good - you sure can't give up in this feline diabetes marathon. ;)

Looking ahead: Finish up your curve today because it's giving us really good information about how he's responding to this dose of Lantus. You'll give him 2 units again tonight as close to 12 hours after the AM shot as you can manage. Take all food away from him in the two hours prior to the pre shot test. You want to know his pre shot BG without the food influence that can raise it.
 
Kris & Teasel said:
Doing well so far today! :) Stubborn is good - you sure can't give up in this feline diabetes marathon. ;)

Looking ahead: Finish up your curve today because it's giving us really good information about how he's responding to this dose of Lantus. You'll give him 2 units again tonight as close to 12 hours after the AM shot as you can manage. Take all food away from him in the two hours prior to the pre shot test. You want to know his pre shot BG without the food influence that can raise it.
Click to expand...

Yes will do the curve finish properly. After that then what? Do i feed him and leave it for him to eat when hes hungry or stay up all night to keep an eye on things? Thats another source of confusion to me. We typically dont fee during night but will if he needs it. He normally gets a can before we go to bed and then another in am.

Also yes I will get a picture asap for my avatar
 
The last test before your preshot test will be at +10 (SS speak). Take all food away then. At +12 do your pre shot test, feed him his supper and give him 2 units again. He doesn't have to eat all his dinner - even a tablespoon or so is enough if he's a slow eater. Lantus is slow in onset so he doesn't need a lot of food on board. He can finish the rest of his dinner after his PM shot.

Try to get a before bed test this evening just to see how he's doing. You can leave a bit of food out overnight or not. I don't feed my guy at night either. If you leave any out you have to know that he'll have eaten all of it by the 2 hours before his AM pre shot test. In the AM it's the usual routine:
  • pre shot test (no food 2 hours before)
  • breakfast (at least some of it)
  • insulin injection.
Is he usually a good eater? That will help you enormously. As far as insulin dose in the days ahead, I'll suggest staying at 2 u for a few days while you get the new testing routine up and running. We need more data to see how he does on this dose before changing it. No need for a curve again tomorrow, just follow the basic testing routine I gave you earlier today.
 
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